Lee Won Seok, Song Joo Young, Shin Jeewon, Choi Sun Hee, Han Man Yong, Lee Kyung Suk
Department of Pediatrics, CHA Ilsan Medical Center, CHA University College of Medicine, Goyang 10414, Republic of Korea.
Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul 05278, Republic of Korea.
J Clin Med. 2025 Feb 16;14(4):1311. doi: 10.3390/jcm14041311.
Respiratory viral infections are a major cause of asthma exacerbations. However, studies examining the association between symptoms, signs, treatments, outcomes of asthma exacerbations, and various respiratory viruses in children are limited. This study aims to investigate the association between respiratory viral infections and clinical symptoms and signs, treatment, and hospital admission in children with asthma exacerbations visiting the pediatric emergency department. This study examined 395 children under 15 years of age who had a previous diagnosis of bronchial asthma, experienced asthma exacerbation, and visited an emergency center between 1 July 2015 and 30 June 2017. Among the 395 participants, respiratory virus polymerase chain reaction (PCR) was conducted in 96 patients (24.3%). The symptoms and signs of asthma exacerbation (dyspnea, tachypnea, chest retraction, wheezing, and gastrointestinal symptoms), treatment (oxygen supplementation and systemic steroid administration), symptom relief within 1 h, and hospital admission were analyzed. Among the 96 patients who underwent respiratory virus PCR, at least one respiratory virus was detected in 72 (75.0%), and over two viruses were detected in 21 children (21.9%). Three common viruses were detected: rhinovirus in 59 (61.5%), adenovirus in 10 (10.4%), and respiratory syncytial virus (RSV) in nine children (9.4%). Rhinovirus infection was associated with tachypnea (adjusted odd ratio (aOR) 4.457, = 0.007), chest retraction (aOR 3.142, = 0.013), and systemic steroid administration (aOR 3.065, = 0.034). Adenovirus infection was associated with oxygen supplementation via nasal cannula (aOR 5.297, = 0.042). Rhinovirus was associated with tachypnea, chest retraction, and systemic steroid administration, while adenovirus was linked to oxygen supplementation in childhood asthma exacerbations. These findings will help clinicians to better observe asthma symptoms, select appropriate treatments, and improve outcomes for asthma exacerbations.
呼吸道病毒感染是哮喘急性加重的主要原因。然而，关于儿童哮喘急性加重的症状、体征、治疗、转归与各种呼吸道病毒之间关联的研究有限。本研究旨在调查前往儿科急诊科就诊的哮喘急性加重儿童中呼吸道病毒感染与临床症状、体征、治疗及住院情况之间的关联。本研究对395名15岁以下曾被诊断为支气管哮喘且经历过哮喘急性加重并于2015年7月1日至2017年6月30日期间前往急诊中心就诊的儿童进行了调查。在这395名参与者中，96例患者（24.3%）进行了呼吸道病毒聚合酶链反应（PCR）检测。对哮喘急性加重的症状和体征（呼吸困难、呼吸急促、胸廓凹陷、喘息及胃肠道症状）、治疗（吸氧及全身使用类固醇）、1小时内症状缓解情况及住院情况进行了分析。在96例行呼吸道病毒PCR检测的患者中，72例（75.0%）检测到至少一种呼吸道病毒，21名儿童（21.9%）检测到两种以上病毒。检测到三种常见病毒：鼻病毒59例（61.5%）、腺病毒10例（10.4%）、呼吸道合胞病毒（RSV）9例（9.4%）。鼻病毒感染与呼吸急促（校正比值比[aOR] 4.457，P = 0.007）、胸廓凹陷（aOR 3.142，P = 0.013）及全身使用类固醇（aOR 3.065，P = 0.034）相关。腺病毒感染与经鼻导管吸氧（aOR 5.297，P = 0.042）相关。在儿童哮喘急性加重中，鼻病毒与呼吸急促、胸廓凹陷及全身使用类固醇相关，而腺病毒与吸氧相关。这些发现将有助于临床医生更好地观察哮喘症状、选择合适的治疗方法并改善哮喘急性加重的转归。
